. Author manuscript; available in PMC: 2023 Jun 12.

Published in final edited form as: J Allergy Clin Immunol Pract. 2023 Feb 14;11(4):1036–1046. doi: 10.1016/j.jaip.2023.02.002

TABLE V.

Possible reasons for a suboptimal response to intra[isp]-muscular epinephrine

• Insufficient or inadequate dosing of epinephrine to treat the reactiony

• Insufficient circulating volume^{73,74,76–80}

• Failure of homeostatic mechanisms to compensate for the anaphylaxis
event^78,79

• Delayed administration of epinephrine^2,19–21

• Adrenaline resistance/tachyphylaxis^3,77

• Ongoing systemic absorption/bioavailability of the allergen (eg, due to unabsorbed food allergen within the gastrointestinal tract)⁸⁰